Ready to Quit Smoking Survey

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Are you ready to quit smoking? Take this survey to help you assess where you are at in the quitting smoking process. This will help you in considering where to proceed with the quit smoking support program so you can have your best chance of success.

Answer "yes" or "no" to the following questions.

1. I have not had a cigarette in more than six months (Yes or No).

2. I have quit smoking within the past six months (Yes or No).

3. I am intending to set a quit date in the next month (Yes or No).

4. I am intending to set a quit date in the next six months (Yes or No).

How to Score your Answers:
If you answered "No" to all four questions, you are in the "Precontemplation" stage. This means that you are not motivated to quit at this time and/or don't believe you need to quit. Here are a few things that might help move you towards being ready to quit smoking:


If you said "No" to questions 1-3 but, "Yes" to question 4, then you are in the "Contemplation" stage. This means that you know that you need to quit but you haven't put together a plan yet on how to go about it. You can benefit from the same steps as in the "Precontemplation" section. You should also check out the quit smoking aids section to see what medications and treatments are available for you to use. Additionally, you should spend a lot of time reviewing the materials in "Step 1" to help you move forward in the quitting process.

If you said "No" to 1 & 2 but, "Yes" to 3 & 4, then you are in the "Preparation" stage. This means you are actively seeking information and support and are ready to quit smoking. You can get a start on the program in "Step 1."

If you said "Yes" to 2 and "No" to question 1, then you are in the "Action" stage. You have quit smoking at this point but can still use lots of support to help you prevent (or cope with) a relapse. It may be helpful to review all steps but, focus on Step 4.

Finally, if you said "Yes" to question 1, then you are in the "Maintenance" stage. You have successfully quit smoking for six months or more. There may still be times of potential relapse ahead so don't let your guard down! Spend some time in Step 4 to be sure you're ready for anything that comes your way.



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